Ethnicity information was collected for all pediatric peritoneal dialysis patients from the End-Stage Renal Disease (ESRD) Clinical Performance Measures (CPM) Project for the period October 2004 through March 2005. Associations between intermediate outcomes and Hispanic ethnicity were determined. Thirty percent (207/696) of patients in the final cohort were Hispanic, 24% (165/696) non-Hispanic black, and 46% (324/696) non-Hispanic white. Hispanics were more likely to be female, older, and have a lower mean height standard deviation score (SDS). There were no significant differences among ethnic/racial groups regarding clearance parameters. More Hispanics had a mean hemoglobin ≥ 11 g/dl compared with non-Hispanic blacks and non-Hispanic whites (77% vs. 55% and 70%, P < 0.0001). More Hispanics compared with non-Hispanic blacks and non-Hispanic whites had a mean serum albumin ≥ 4.0/3.7 g/dl [bromcresol green/bromcresol purple laboratory method (BCG/BCP)] (50% vs. 24% and 27%, respectively, P < 0.0001). In multivariate analyses, Hispanics remained significantly more likely to achieve a mean serum albumin ≥ 4.0/3.7 g/dl (BCG/BCP) compared with non-Hispanic whites (referent) and were as likely to achieve clearance and hemoglobin targets. Pediatric Hispanic peritoneal dialysis patients experience equivalent or better intermediate outcomes of dialytic care compared with non-Hispanics. Further study is needed to understand associations of Hispanic ethnicity with outcomes such as hospitalization, transplantation, and mortality.
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Healthy People 2010: Understanding and Improving Health (2nd edn) (2000) Washington, DC: U.S. Department of Health and Human Services, U.S. Government Printing Office
Frankenfield DL, Rocco MV, Roman SH, McClellan WM (2003) Survival advantage for adult Hispanic hemodialysis patients? Findings from the end-stage renal disease clinical performance measures project. J Am Soc Nephrol 14(1):180–186
Frankenfield DL, Rocco MV, Frederick PR, Pugh J, McClellan WM, Owen WF Jr (1993) Racial/ethnic analysis of selected intermediate outcomes for hemodialysis patients: results from the 1997 ESRD Core Indicators Project. Am J Kidney Dis 34(4):721–730
Pugh JA, Tuley MR, Basu S (1994) Survival among Mexican-Americans, non-Hispanic whites, and African-Americans with end-stage renal disease: the emergence of a minority pattern of increased incidence and prolonged survival. Am J Kidney Dis 23(6):803–807
Medina RA, Pugh JA, Monterrosa A, Cornell J (1996) Minority advantage in diabetic end-stage renal disease survival on hemodialysis: due to different proportions of diabetic type? Am J Kidney Dis 28(2):226–234
Centers for Disease Control and Prevention (1992) Incidence of treatment for end-stage renal disease attributed to diabetes mellitus, by race/ethnicity - Colorado (1982–1989). MMWR 41(4):845–848
Sequist TD, Narva AS, Stiles SK, Karp SK, Cass A, Ayanian JZ (2004) Access to renal transplantation among American Indians and Hispanics. Am J Kidney Dis 44(2):344–352
Frankenfield DL, Atkinson MA, Fivush BA, Neu AM (2006) Outcomes for adolescent Hispanic hemodialysis patients: findings from the ESRD Clinical Performance Measures Project. Am J Kidney Dis 47(5):870–878
Frankenfield DL, Roman SH, Rocco MV, Bedinger MR, McClellan WM (2004) Disparity in outcomes for adult Native American hemodialysis patients? Findings from the ESRD Clinical Performance Measures Project, 1996 to 1999. Kidney Int 65(4):1426–1434
Blagg CR, Liedtke RJ, Batjer JD, Racoosin B, Sawyer TK, Wick MJ, Lawson L, Wilkens K (1993) Serum albumin concentration-related Health Care Financing Administration quality assurance criterion is method-dependent: revision is necessary. Am J Kidney Dis 21(2):138–144
Carfray A, Patel K, Whitaker P, Garrick P, Grittiths GJ, Warwick GL (2000) Albumin as an outcome measure in haemodialysis patients: the effect of variation in assay method. Nephrol Dial Transplant 15(11):1819–1822
Kuczmarski RJ, Ogden CL, Grummer-Strawn LM, Flegal KM, Guo SS, Wei R, Mei Z, Curtin LR, Roche AF, Johnson CL (2000) CDC growth charts: United States. Adv Data 314:1–27
Ifudu O, Dawood M, Iofel Y, Valcourt JS, Friedman EA (1999) Delayed referral of black, Hispanic, and older patients with chronic renal failure. Am J Kidney Dis 33(4):728–733
Pugh JA, Medina RA, Cornell JC, Basu S (1995) NIDDM is the major cause of diabetic end-stage renal disease. More evidence from a tri-ethnic community. Diabetes 44(12):1375–1380
Kausz AT, Obrador GT, Arora P, Ruthazer R, Levey AS, Pereira BJ (2000) Late initiation of dialysis among women and ethnic minorities in the United States. J Am Soc Nephrol 11(12):2351–2357
Staub L, Morgenstern LB (2000) Stroke in Hispanic Americans. Neurol Clin 18(2):291–307
Schiff M, Key CR, Gilliland FD, Becker TM (1997) Ethnic differences in uterine corpus cancer incidence and mortality in New Mexico's American Indians, Hispanics and non-Hispanic whites. Int J Epidemiol 26(2):249–255
Canto JG, Taylor HA, Jr., Rogers WJ, Sanderson B, Hilbe J, Barron HV (1998) Presenting characteristics, treatment patterns, and clinical outcomes of non-black minorities in the National Registry of Myocardial Infarction 2. Am J Cardiol 82(9):1013–1018
Meyerowitz BE, Richardson J, Hudson S, Leedham B (1998) Ethnicity and cancer outcomes: behavioral and psychosocial considerations. Psychol Bull 123(1):47–70
Liao Y, Cooper RS, Cao G, Durazo-Arvizu R, Kaufman JS, Luke A, McGee DL (1998) Mortality patterns among adult Hispanics: findings from the NHIS, 1986–1990. Am J Public Health 88(2):227–232
Franzini L, Ribble JC, Keddie AM (2001) Understanding the Hispanic paradox. Ethn Dis 11(3):496–518
Abraido-Lanza AF, Dohrenwend BP, Ng-Mak DS, Turner JB (1999) The Latino mortality paradox: a test of the "salmon bias" and healthy migrant hypotheses. Am J Public Health 89(10):1543–1548
Markides KS, Coreil J (1986) The health of Hispanics in the southwestern United States: an epidemiologic paradox. Public Health Rep 101(3):253–265
Ramirez RR, de la Cruz GP (2003) The Hispanic population in the United States: March 2002. U.S. Census Bureau, Washington, D.C.
U.S. Interim Projections by Age, Sex, Race, and Hispanic Origin (2004) U.S. Census Bureau. Available at: http://www.census.gov/ipc/www/usinterimproj/natprojtab01a.pdf. Cited 15 Feb 2007.
Nzerue CM, Demissochew H, Tucker JK (2002) Race and kidney disease: role of social and environmental factors. J Natl Med Assoc 94(8 Suppl):28S–38S
Centers for Medicare & Medicaid Services (2006) 2005 Annual Report, End Stage Renal Disease Clinical Performance Measures Project. Am J Kidney Dis 48(Suppl 2):S1–S106
USRDS (2005) Annual Data Report: Atlas of End-Stage Renal Disease in the United Sates. U.S. Renal Data System, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD
Powe NR, Tarver-Carr ME, Eberhardt MS, Brancati FL (2003) Receipt of renal replacement therapy in the United States: a population-based study of sociodemographic disparities from the Second National Health and Nutrition Examination Survey (NHANES II). Am J Kidney Dis 42(2):249–255
Freedman DS, Khan LK, Serdula MK, Ogden CL, Dietz WH (2006) Racial and ethnic differences in secular trends for childhood BMI, weight, and height. Obesity 14(2):301–308
Perez-Padilla R, Rojas R, Torres V, Borja-Aburto V, Olaiz G, Group TEW (2006) Obesity among children residing in Mexico City and its impact on lung function: a comparison with Mexican-Americans. Arch Med Res 37(1):165–171
Sorof JM, Hawkins EP, Brewer ED, Boydstun, II, Kale AS, Powell DR (1998) Age and ethnicity affect the risk and outcome of focal segmental glomerulosclerosis. Pediatr Nephrol 12(9):764–768
Hall YN, Fuentes EF, Chertow GM, Olson JL (2004) Race/ethnicity and disease severity in IgA nephropathy. BMC Nephrol 5:10
Contreras G, Lenz O, Pardo V, Borja E, Cely C, Iqbal K, Nahar N, de La Cuesta C, Hurtado A, Fornoni A, Beltran-Garcia L, Asif A, Young L, Diego J, Zachariah M, Smith-Norwood B (2006) Outcomes in African Americans and Hispanics with lupus nephritis. Kidney Int 69(10):1846–1851
National Kidney Foundation; Kidney Disease Outcomes Quality Initiative (NKF K/DOQI) (2006) Clinical Practice Recommendations for Peritoneal Dialysis Adequacy; Guideline 6: Pediatric Peritoneal Dialysis
Rocco MV, Frankenfield DL, Frederick PR, Pugh J, McClellan WM, Owen WF (2000) Intermediate outcomes by race and ethnicity in peritoneal dialysis patients: results from the 1997 ESRD Core Indicators Project. National ESRD Core Indicators Workgroup. Perit Dial Int 20(3):328–335
Gunnell J, Yeun JY, Depner TA, Kaysen GA (1999) Acute-phase response predicts erythropoietin resistance in hemodialysis and peritoneal dialysis patients. Am J Kidney Dis 33(1):63–72
Diskin CJ, Stokes TJ, Dansby LM, Radcliff L, Carter TB (2006) Can acidosis and hyperphosphatemia result in increased erythropoietin dosing in haemodialysis patients? Nephrology 11(5):394–399
Al-Hilali N, Al-Humoud H, Ninan VT, Nampoory MR, Puliyclil MA, Johny KV (2007) Does Parathyroid Hormone Affect Erythropoietin Therapy in Dialysis Patients? Med Princ Pract 16:63–67
Danielson B (1995) R-HuEPO hyporesponsiveness-who and why? Nephrol Dial Transplant 10(Suppl 2):69–73
National Kidney Foundation; Kidney Disease Outcomes Quality Initiative (NKF K/DOQI) (2000) Clinical Practice Guidelines for Adults on Maintenance Dialysis: Evaluation of Protein-Energy Nutrition Status
Brem AS, Lambert C, Hill C, Kitsen J, Shemin DG (2002) Prevalence of protein malnutrition in children maintained on peritoneal dialysis. Pediatr Nephrol 17(7):527–530
Boehmer U, Kressin NR, Berlowitz DR, Christiansen CL, Kazis LE, Jones JA (2002) Self-Reported vs Administrative Race/Ethnicity Data and Study Results. Am J Public Health 92(9):1471–1472
Kressin NR, Chang BH, Hendricks A, Kazis LE (2003) Agreement between administrative data and patients' self-reports of race/ethnicity. Am J Public Health 93(10):1734–1739
Rosenberg HM, Maurer JD, Sorlie PD, Johnson NJ, MacDorman MF, Hoyert DL, Spitzler JF, Scott C (1999) Quality of death rates by race and Hispanic origin: a summary of current research. Vital Health Stat 2(128):1–13
Blustein J (1994) The reliability of racial classifications in hospital discharge abstract data. Am J Public Health 84(6):1018–1021
The views expressed in this manuscript are those of the authors and do not necessarily reflect official policy of the Centers for Medicare & Medicaid Services.
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Atkinson, M.A., Neu, A.M., Fivush, B.A. et al. Ethnic disparity in outcomes for pediatric peritoneal dialysis patients in the ESRD Clinical Performance Measures Project. Pediatr Nephrol 22, 1939–1946 (2007) doi:10.1007/s00467-007-0593-0
- Renal replacement therapy
- KDOQI target